Statement of Income, Assets, Debts and Living Expenses
Wisconsin · Wisconsin Court System · Effective September 8, 2022
This form asks for detailed financial information, including income, assets, debts, and monthly living expenses. It requires the person filling it out to state that all the information provided is true and accurate.
The court describes it as: To provide financial information to the court. This form is always used when it appears that a child/juvenile may be placed outside of his or her home in a court proceeding or when appropriate. Available in Spanish.
Where this fits in a case
General & infoInformation / general use — not tied to one step of a case
This form is used in a court proceeding when it seems a child or juvenile might have to live outside of their home.
Either party may file.
Official instructions
How-to guides published by the court for this form.
Common questions
- Who fills out this form?
- The person completing the form must state that the information is true and accurate under penalty of perjury.
- What kind of information does it ask for?
- It asks for details about monthly income, what assets a person owns, long-term debts, and regular monthly expenses.
- When should this form be returned?
- The form should be returned to the juvenile court clerk by the time listed on the court order.
Revision history
No changes recorded since we started tracking this form on October 10, 2026. The current version took effect September 8, 2022.
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